The goal of the Fellowship Program is to equip our fellows with the appropriate skills to allow them to excel in a career path of their choice. Two fellows are recruited each year for a three-year fellowship. The program is designed to provide training in patient management, procedural skills, teaching, and research. A strong clinical experience, managing both inpatients and outpatients with gastrointestinal and liver disorders is provided. Fellows are trained to achieve competence in diagnostic and therapeutic endoscopy as well as liver biopsies and advanced manometric techniques. Fellows are involved in the liver transplant program and will be offered a rotation in pediatric Gastroenterology, motility and nutrition. In addition to these clinical activities, fellow are involved in research and journal club conferences, which are aimed at providing a core of knowledge in pathophysiology and critical literature review. Fellows will be involved in teaching the medical students and residents rotating on the service. A significant research experience will be provided during the second year to training. The third year is individually tailored to the career goals of the fellow and includes advanced therapeutic endoscopic techniques.

The Milton S. Hershey Medical Center of The Pennsylvania State University is the major teaching hospital for The Pennsylvania State University College of Medicine. It is also the major tertiary care hospital for central Pennsylvania with a catchment area of more than two million people. The University Hospital, Basic Science Wings of the College of Medicine, the Biomedical Research Building, and other associated facilities including the Fitness Center, Child Day Care Center, and the Animal Research Farms are situated on one site on the western edge of Hershey, 11 miles east of Harrisburg, the State Capitol. The mission of the College of Medicine and the University Hospital is excellence in patient care, teaching, and research.

The Section of Gastroenterology and Hepatology is located in the Biomedical Research Building where the laboratories are adjacent to the academic offices. Additional office space which includes a library/conference area and the main library are located in the College Wing of University Hospital. In addition, a new Endoscopy Unit opened in 1993 with expanded facilities. Medical literature is available in the Library in the College of Medicine and the Endoscopy Unit.

First Year

The first year of the fellowship involves intensive clinical training with emphasis on the pathophysiological approach to diagnosis and management of a broad spectrum of GI and liver diseases. The first-year fellow is responsible for the management of a busy Gastroenterology Inpatient and Consultation Service. Over 500 consults per year provide a broad base of clinical experience. The consultative and inpatient Gastroenterology team consists of an attending, first-year fellow, a rotating medicine resident, and one or two fourth-year medical students. Daily teaching rounds are conducted seven days a week. Night and weekend call are shared by all fellows. The two first-year fellows spend equal time on the inpatient service and endoscopy rotation. The first-year fellows are taught the cognitive and procedural skills in diagnostic endoscopy, including upper endoscopy and colonoscopy. Upper endoscopic procedures include esophageal dilatation, pneumatic dilatation, percutaneous gastrostomy tube placements, small bowel biopsy, and therapeutic modalities to control upper gastrointestinal bleeding including bicap, heater probe, and injection therapy. Liver biopsies, along with injection sclerotherapy and banding of varices and placement of Sengstaken Blakemore tubes in the treatment of bleeding esophageal varices, are taught in the management of patients with liver disease. Lower gastrointestinal endoscopic procedures include flexible sigmoidoscopy and colonoscopy with polypectomy. One half-day clinics provide a broad experience in the management of patients in the outpatient setting.

Second Year

The second-year fellowship provides training in more advanced procedural skills and an introduction to research. The procedures that are performed by the second-year fellow include more colonoscopy training, diagnostic ERCP, and treatment of malignant strictures by YAG laser. For three to four months, the second year fellow is assigned to the Liver Service. This service includes attendance at the weekly Liver Transplant Clinic where prospective and post-operative patients with liver diseases are manager. A weekly liver transplant management meeting is held for one hour. Each second year fellow is assigned for one month to the Motility Service where the fellow becomes familiar with esophageal and anorectal manometry.

The fellows are exposed to clinical or basic science research during the second year. Four months of protected time during which the fellows are not involved in clinical activities other than outpatient clinic one half day per week. It is expected that fellows will submit an abstract to the national meetings of the American Gastroenterological Association, the American Society for Gastrointestinal Endoscopy, the American College of Gastroenterology, or the American Association of Liver Diseases.

Third Year

The structure of the third year is designed to enable each individual fellow to become competitive in their career path. Third-year fellows are involved in therapeutic ERCP, including sphincterotomy, stone extraction, and stent placement in the biliary and pancreatic ducts. Exposure to endoscopic ultrasound is available. For those fellows interested in pursuing an academic career path, the third year will be designed to enhance their basic science or clinical research experience and to enable them to achieve funding for additional training, if necessary, as well as providing the clinical experience to develop expertise in a specific clinical area. For those interested in a career in private practice, an intensive experience in therapeutic endoscopy will be designed. Rotations with the Pediatric Gastroenterology group, Motility and electrogastrogram are included in the third year of fellowship training.

In addition to the outpatient and inpatient clinical experience, there are a number of formal and informal teaching conferences within the division. Fellows are extensively involved in all these conferences.

In addition to the in-house conferences, the Section of Gastroenterology and Hepatology is active in the Central Pennsylvania Gut Club. Fellows attend the annual meeting of the major gastroenterology or liver societies. If they have research based abstracts accepted for presentation, they will be able to attend additional conferences.

There is an opportunity to enroll in the graduate program of the Public Health Sciences Department. Recent GI fellows have successfully completed MS degrees during their GI fellowship period. To learn more about the Public Health Sciences Department graduate program, visit their website.